Droopy eyelids after botox injection to remove wrinkles

Hanoi A few days after getting Botox injections at a spa to remove wrinkles, the 37-year-old woman's forehead had many granulomas and her eyelids drooped.

On May 26, Dr. Vu Thai Ha, Head of the Department of Stem Cell Research and Application, Central Dermatology Hospital, informed about this case at the 6th National Cosmetic Dermatology Conference , to warn about complications caused by injecting botox of unknown origin or using incorrect techniques, not ensuring sterility.

According to the doctor, the patient had many wrinkles on her forehead and the corners of her eyes. She had botox injections to remove wrinkles at a massage facility (spa). After the injection, her eyelids drooped, affecting her vision, and many granulomas and papules appeared on her forehead. The doctor diagnosed the patient with serious complications after injecting botox of unknown origin.

"The patient received skin treatment, but the problem of drooping eyelids cannot be treated immediately. It takes at least 2-3 months to recover from the accident," said Dr. Ha.

Botox is short for botulinum toxin, a toxin produced by the bacterium Clostridium botulinum. This toxin blocks nerve impulses to muscles, paralyzing muscle movement. Because of its paralyzing effect, botox is used in medicine to treat involuntary muscle contractions.

There are 7 types of botulinum bacteria (A, B, C, D, E, F and G), but only two types A and B are used in medicine, of which type A accounts for 90-95% - which is botox. Since 1992, botulinum type A has been used in the cosmetic industry to help reduce wrinkles on the forehead, eyebrows, and corners of the eyes, and slim the jawline and calves.

According to Dr. Ha, many patients get Botox injections at small cosmetic facilities, with incorrect injection techniques, unsanitary conditions, and use of Botox of unknown origin and incorrect dosage, leading to complications. The dose of Botox that can cause death for a person weighing 70 kg is 2,000-3,000 IU. Normally, a bottle of Botox contains about 100 units (UI). The dose used in cosmetic treatment of large muscle areas is on average 60 to 400 IU. In smaller cosmetic areas, such as eye wrinkle removal, only 10-15 IU is needed, and 20-30 IU of Botox for the forehead is safe because it is not enough to cause poisoning.

Patients get their skin examined at the Central Dermatology Hospital. Photo: Le Nga — Patients get their skin examined at the Central Dermatology Hospital. Photo: *Le Nga*

Associate Professor, Dr. Le Huu Doanh, Director of the Central Dermatology Hospital, said that the demand for beauty has increased after the Covid-19 pandemic, and the number of complications has also increased.

In 2022, the Central Dermatology Hospital received nearly 400,000 visits, with about 50-100 patients coming for treatment each month due to complications after unsafe cosmetic procedures. For example, a 30-year-old girl suffered complications after receiving botox injections to slim her jaw at a spa. The patient had an abscess in her cheek area, and doctors had to cut it open to drain the pus and use antibiotics for a long time to control the infection.

Doctors recommend that when doing beauty treatments or getting Botox injections, you should choose a reputable medical facility and avoid buying and using Botox that is not available or of unknown origin. The Botox injection process must be performed by a specialist who understands the anatomy and injects correctly and in the right dose to avoid complications.

Le Nga

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